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Author
Topic: A context for many of the IAC reports being discussed (Read 5257 times)

This is an editorial piece by Dr. Anthony S. Fauci who will be presenting a report on Wednesday.

I hope that this can provide some basic consumer context of what is being discussed in recent medical reports (and help turn down the volume a bit on talk of imminent cures ) that is unfortunately circulating.

While I agree with the idea that we need to be optimistic and have hope, I'm saddened to see that some are pursuing that notion by misrepresenting some findings and news reports beyond actual fact. Also, I hope it helps refute some of what I've read on certain threads that dismiss the importance of ARV therapy accomplishments and developments; such arguments are disheartening, not fully truthful, and counter-productive.

If you read the full article he does agree that the search for a vaccine/cure is important, and agrees that we need to focus on this, but clearly is saying that the vaccine and/or cure is not happening today, tomorrow, the immediate future nor will be happening at the expense of the "functional cure" of ARV therapy options that are being discussed here and now, and which believe are exciting and gives me more then enough hope.

The emphasis in the below quotes are mine.My talk on Wednesday, is called "Looking to the Future: New Directions in HIV/AIDS Research" and will look at all these issues, and the many challenges (and opportunities) in AIDS science. But I hope to leave the audience with at least a tentative answer to an important question I get all the time: Will we ever have a cure or a vaccine for HIV?

Despite our considerable success in managing HIV infection and improving the length and quality of life for people living with HIV, there is no well-documented case of anyone being truly cured of HIV disease. This is because HIV is unlike virtually any other virus in its ability to hide from the immune system in protected cellular sanctuaries that we call "latent reservoirs."

We know that these reservoirs are established within days of infection, and even our most potent combinations of anti-HIV drugs are unable to purge the virus from these hiding places, even in people who have been on therapy for a decade or more. If you take a patient off his or her anti-HIV therapy, the virus hiding in these reservoirs springs back, and soon billions of viruses are renewing their assault on immune system cells and other organs.

Our best hope for eradicating HIV from the reservoirs may be to diagnose and treat people aggressively very early in infection, before the reservoirs have become too large. Our laboratory and other groups are testing this approach with intensive regimens of new drugs that prevent the virus from entering cells or from inserting its genes into a cell's DNA.

Even if the virus is not completely eradicated, such early, intense treatment, perhaps with the help of immune-boosting drugs, might keep the reservoir small -- and the immune system strong -- thereby allowing a person to come off therapy. This would be a "functional" cure. Other approaches are being pursued as well.

I'm saddened to see that some are pursuing that notion by misrepresenting some findings and news reports beyond actual fact. Also, I hope it helps refute some of what I've read on certain threads that dismiss the importance of ARV therapy accomplishments and developments; such arguments are disheartening, not fully truthful, and counter-productive.

It's not an unusual tack for those that have not fully come to terms with their life-threatening diseased body. Combine that with a keyboard and an internet connection and things quickly become unfortunate.

I still think there's a large amount of people that simply don't realize how much HIV treatment has improved in the last 5 years, along with the newest meds most of which only a small group of people on this board are currently taking.

Everything with this disease is done in small increments. Yeah, it would be great for some wild, new thing to appear suddenly but there are CONSTANT puff pieces that then disappear in a month. It's tiring, frankly.

Otherwise Fauci has been heavily involved in HIV research since the beginning and I suppose we all owe him a large amount of thanks.

BTW I wanted to mention that headline of the linked article is a great example of how the media sometimes misses the mark about the very story they are covering. Perhaps in and of itself is a lesson about being careful of how one reads media coverage of the IAC

BTW I wanted to mention that headline of the linked article is a great example of how the media sometimes misses the mark about the very story they are covering. Perhaps in and of itself is a lesson about being careful of how one reads media coverage of the IAC

I am certain that the headline is not one suggested by Dr. Fauci.

Not to pick nits, but the title of the CNN article, "AIDS chief still hopeful for eventual vaccine, cure" seems in line with this statement at the end of the article:

"let me give you the quick bottom line: I am cautiously optimistic that we will be able to cure some patients under certain circumstances, and I am also cautiously optimistic that we will develop a vaccine that will protect some people against HIV infection, or slow the progression of disease in some patients who do get infected."

Is that comment not "hopeful"? How was the media, i.e. CNN, "misleading"?

My point was that those who don't fully read the article and take the time to understand what it is discussing may only focus on something like the headline and one paragraph, and might miss the whole substance in the majority of the piece: the idea of a "cure" is not something in our immediate future nor something that will necessarily rid people of HIV.

A good example of this point of how the headline misses the mark is is the paragraph that you quote from the article. (bolded emphasis is mine)

"let me give you the quick bottom line: I am cautiously optimistic that we will be able to cure some patients under certain circumstances, and I am also cautiously optimistic that we will develop a vaccine that will protect some people against HIV infection, or slow the progression of disease in some patients who do get infected."

Does this sound like a CURE in the capital letter sense that most people seem to equate the word with?

Please remember that the point of my post is that we understand the context of news items and reports coming out of the IAC and not to get caught up on individual paragraphs, headlines and points.

Wow...that's some serious parsing you've done there. Maybe I'm just a glass half full kind of chap, but I thought Dr, Fauci's comments were indeed "hopeful" as stated in the headline. You seem to be awfully presumptuous when you assume people don't read things through like you do. I prefer to give the benefit of the doubt.

Wow...that's some serious parsing you've done there. Maybe I'm just a glass half full kind of chap, but I thought Dr, Fauci's comments were indeed "hopeful" as stated in the headline. You seem to be awfully presumptuous when you assume people don't read things through like you do. I prefer to give the benefit of the doubt.

I actually think you are missing Iggy's point here. You have been doing the parsing here -- you are harping over the CNN headline that he mentioned and missing the entire point.He has stated that optimism and hope are good and important. What he is pointing out is that people take headlines that overblow that hope and run with it -- thinking that they are on to the sure cure for this virus. We see it all the time in these rooms -- people read an article in some journal or on some website (sometimes only a piece of said article) and come in here trumpeting that the end of HIV/AIDS is near. We will all soon be rid of this disease. He is trying to help people put things into perspective when reading. Hope is good and necessary, but having unrealistic hopes can really lead to crushing lows when the flavor of the day doesn't pan out. Reread his post.Mike

This is an editorial piece by Dr. Anthony S. Fauci who will be presenting a report on Wednesday. [...]there is no well-documented case of anyone being truly cured of HIV disease. This is because HIV is unlike virtually any other virus in its ability to hide from the immune system in protected cellular sanctuaries that we call "latent reservoirs."

Uh, big news! That's worth knowing for the future ("the future" being a dozen of years ago).

By the way, how is that dr. Hütter's "transplanted patient" seems to have destroyed his reservoirs in a couple of months (no more HIV-DNA in his gut, for instance)?I'd like to remind you also of a comment on that exceptional result: "It’s interesting, but the bigger picture is that doing stem cell transplants is not a realistic approach for curing AIDS." What a bright example of a true scientific mind!...And who made the comment? Tae-Wook Chun, Fauci's associate (see ° below)!!!

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Our best hope for eradicating HIV from the reservoirs may be to diagnose and treat people aggressively very early in infection, before the reservoirs have become too large. Our laboratory and other groups are testing this approach with intensive regimens of new drugs that prevent the virus from entering cells or from inserting its genes into a cell's DNA.

The worst (honest) idea is better than this trivial and useless "plan": finding people infected the week before and treat them "aggressively" for 7.7 years (° Fauci/Chun's notorious estimate) with Selzentry, Isentress and Fuzeon.Soooooooooo brilliant and exciting, this "realistic approach for curing (under certain circumstances, some patients') AIDS"!!!

I'm sorry you've taken my posts the way that you have, but I'm just not going to get into a semantics argument or a debate of who is a cynic and who is an optimist. Such debates are counter to the point and distract.

Leit,

I question your dismissive response of Dr. Fauci's reminder that there is no well documented case of any one being truly cured of HIV or that they have been able to actually rid a person of all the latent reseviors of HIV.

Do you for some reason think the study you cite shows the opposite? It doesn't.

I also think your overall tone of mock and ridicule (and I believe misrepresentations) about Dr. Fauci and ARV therapies is neither warranted nor welcome in this discussion. It very much fits the bill of what I meant in my opening post by, "Also, I hope it helps refute some of what I've read on certain threads that dismiss the importance of ARV therapy accomplishments and developments; such arguments are disheartening, not fully truthful, and counter-productive."

Do you for some reason think the study you cite shows the opposite? It doesn't.

Maybe, but it suggests it, at the very least. And anyway, they better study it in depth.

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certain threads that dismiss the importance of ARV therapy accomplishments and developments; such arguments are disheartening, not fully truthful, and counter-productive."

As Siliciano has explained today, in terms of efficacy and in the prospect of a cure, HAART has already reached its top. So, scientifically speaking and disregarding toxicity/friendliness (though VERY important for us), is of very little interest.

Maybe, but it suggests it, at the very least. And anyway, they better study it in depth.

There is no maybe here. The study that you cite absolutely does not counter Fauci's comments. Nor does it imply anything different from what Fauci said in the article and which you took exception with.

For the record for anyone following who may not understand the simplicity of this:

No one has been cured of HIV and they have not been able to remove the latent reservoir of HIV from any person.